completely at one breast before switching to the
other, even if the infant becomes satiated before
switching or before finishing the second breast.
The infant generally will pull away from one
breast when ready to switch. Following the
infant’s lead in this way, rather than breastfeeding
by the clock, allows the infant to receive maxi-
mum nutritional benefit from breastfeeding.
Though conventional wisdom has long held that
the mother should switch the infant from one
breast to the other to provide equal time at each
breast under the premise that this practice would
to stimulate and sustain the most ideal milk pro-
duction, recent research suggests the infant may
not receive balanced nutrition with such an
approach. As well, sucking provides emotional
comfort for the infant.
Though breastfeeding is a natural process, the
process of breastfeeding does not come naturally
for most women. It takes time and patience for
the mother to synchronize with the baby’s needs
and preferences. Birthing centers have lactation
specialists who can help new mothers establish
effective breastfeeding. New mothers often worry
the infant is not receiving enough nourishment.
The most accurate measure of this is the infant’s
steady and appropriate weight gain and develop-
ment. The breasts seldom drain completely of
milk, and the infant may nurse more aggressively
at some feedings than others.
Care of the BreastsThe mother’s breasts, especially the nipples, are
often tender during the first few weeks of breast-
feeding. It is important for the infant to latch
around a good portion of the areola as well as the
nipple when nursing, which properly stimulates
the lactiferous glands as well as eases CHAFINGand
soreness of the nipples. A lactation specialist can
help a new mother find the nursing positions that
are most effective.
Washing the breasts with warm water after
breastfeeding and allowing them to air dry helps
prevent irritation and chafing. A nursing bra pro-
vides extra support for the breasts, which are
quite heavy and enlarged during breastfeeding.
Nursing pads inserted inside the bra protect leak-
ing milk from staining clothing. Because many
substances pass from the mother’s body into the
breast milk, the woman should check with her
health-care provider before taking over-the-
counter (OTC) medications. Certain foods appear
to bother some infants, probably altering the taste
or smell of the breast milk.Expressing and Storing Breast Milk
Many women express (pump) milk from their
breasts to store for feeding the baby when breast-
feeding is not possible, such as after the woman
returns to work. This allows other people to use a
bottle to feed breast milk to the baby. Expressed
breast milk will remain fresh for one week when
refrigerated and for four months when frozen.
Breast pumps simulate the rhythmic pressure of
nursing, initiating the letdown REFLEXand releas-
ing milk. It may take longer to express full breasts
when pumping than when the baby nurses,
though it is important to get as much milk as pos-
sible so milk production remains constant. The
breasts adjust how much milk they produce
according to the demand for milk.
See also ANTIBODY; BREAST HEALTH; MASTITIS.breast health Measures a woman can take
throughout her life to maintain the best possible
health for her breasts. Because there is such wide
variation around what is “normal” when it comes
to breasts, health experts urge women to become
familiar with the appearance and feel of their own
breasts so they can easily and quickly detect
changes that warrant further medical evaluation.
A comprehensive approach combines lifestyle
habits that support BREASThealth with monthly
BREAST SELF-EXAMINATION, regular breast exams
from a health-care provider, and MAMMOGRAM
(when age appropriate).
A woman’s breasts are somewhat dynamic in
that they undergo cyclic changes that follow the
MENSTRUAL CYCLE. The glandular tissues respond to
ESTROGENSand PROGESTERONEin the woman’s BLOOD
circulation. The same hormonal patterns that pre-
pare the UTERUSfor PREGNANCYalso prepare the
breasts to produce milk. They also cause cyclic
changes in the breasts. Many women find their
breasts become tender and somewhat swollen
during the week before their menstrual periods—
the luteal or secretory phase of the menstrual
cycle when estrogen levels are especially high.254 The Reproductive System